Healthcare Provider Details

I. General information

NPI: 1770035248
Provider Name (Legal Business Name): CELISA MCGRONE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 RITCHIE HWY
ARNOLD MD
21012
US

IV. Provider business mailing address

2799 LAWRENCEVILLE HWY STE 104
DECATUR GA
30033-2517
US

V. Phone/Fax

Practice location:
  • Phone: 410-757-7600
  • Fax: 410-626-8043
Mailing address:
  • Phone: 404-297-3440
  • Fax: 770-741-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60790736
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN232254
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR232956
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN60790807
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: